[WEB PAGE] What Impact Will Moderate or Severe TBI Have on a Person’s Life? – BrainLine

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The effects of moderate to severe TBI can be long lasting or even permanent. While recovery and rehabilitation are possible, most people with moderate to severe TBI face life challenges that will require them to adapt and adjust to a new reality.

Moderate to severe TBI can cause permanent physical or mental disability. Because polytrauma is common with moderate to severe TBI, many patients face additional disabilities as a result of other injuries. Even patients who appear to recover fully may have some long-term symptoms that never go away.

Challenges with work and completing tasks that were once routine can be much more difficult than before the injury. Some patients find that the skills and abilities that they used before the injury to meet these challenges are not as sharp as they once were.

These ongoing challenges can also affect the patient’s personal life. People who have experienced brain injuries may take longer to do cognitive or “thinking” tasks associated with memory, such as coming up with the correct change in the checkout line at the grocery store or placing an order at a restaurant. Family relationships will almost certainly change, and in some cases the patient will be totally dependent on their caregivers.

Despite the advances in early diagnosis and treatment of moderate to severe TBI, the fact remains that traumatic brain injury will be a life-changing experience for many patients. Helping the patient, family members, and caregivers to cope with these long-term consequences is an important part of TBI rehabilitation.

Motor Deficits and Disabilities

For many patients, the damage to the brain resulting from a moderate to severe TBI may lead to life-long disabilities or motor deficits. The term disability in relationship to TBI means a loss of physical or mental function caused by damage to the brain. Motor deficits refer specifically to the effect of damage on motor skills or movement.

Examples of disabilities and motor deficits caused by moderate to severe TBI include:

• Paralysis
• Spasticity (muscle stiffness) or uncontrolled movements
• Problems walking, talking, or swallowing
• Difficulty carrying or moving objects
• Vision problems
• Loss of fine motor skills, such as buttoning a shirt
• Inability to recognize something based on touch
• Difficulty thinking and remembering
• Difficulty with social relationships

Other challenges that a patient with moderate or severe TBI may experience include:

• Difficulty making and keeping personal and professional relationships
• Difficulty being part of social activities
• Difficulty taking part in recreational or leisure activities
• The decreased ability or inability to keep a job or go to school

During the rehabilitation and transition phases of TBI treatment, members of the healthcare team will provide information to the patient and their family members about dealing with these issues. Specific tools and coping strategies will be suggested. Examples of coping strategies and tools include:

• Writing a detailed list of steps needed to complete a task
• Using prompts or visual aids to help remember things
• Using assistive devices to move around, such as a walker or a wheelchair

Learning new ways to do things is a very important part of recovery.

Other Potential Effects

The long-term symptoms of TBI can be divided into several categories, including physical changes, cognitive effects, sensory effects, perceptual effects, social-emotional changes, and others. You’ll find a partial list of these symptoms and possible effects below. Keep in mind that the severity and duration of symptoms and effects will vary greatly from one patient to another, depending on the severity of the TBI.

Physical effects

• Sleep disorders
• Loss of stamina (easily fatigued)
• Appetite changes
• Difficulty swallowing
• Physical paralysis or spasticity
• Chronic pain
• Loss of control of bowel and bladder functions
• Seizures
• Difficulty regulating body temperature
• Hormonal changes

Cognitive effects

• Difficulty with attention, focus, or concentration
• Distractibility
• Memory problems
• Slow speed of processing
• Confusion
• Perseveration, which is the abnormal persistent repetition of a word, gesture, or act
• Impulsiveness
• Difficulty with language processing
• Problems with executive functions, which include planning, cognitive flexibility, abstract thinking, rule acquisition (determining right from wrong), initiating appropriate actions, and inhibiting inappropriate actions

Speech and language effects

• Aphasia (difficulty with talking or expressing ideas, understanding everyday language, and problems with reading and writing). Types of aphasia can include:
  • Receptive aphasia, which involves difficulty understanding the spoken word, or
  • Expressive aphasia, which means the patient knows what they wish to say but is unable to get the words out. In some cases, the patient is able to perceive and comprehend both spoken and written language, but is unable to repeat what they see or hear.
• Slurred speech
• Speaking very fast or very slow
• Problems with reading comprehension

Sensory and perceptual effects

• Difficulty recognizing and distinguishing between touch and pressure sensations
• Difficulty perceiving temperature
• Difficulty perceiving movement and positions of the arms and legs
• Difficulty with fine discrimination (for example, distinguishing between small everyday objects, like coins)
• Difficulty integrating and understanding information gained through the five senses (sight, smell, touch, hearing, and taste)

Effects on vision

• Partial or total loss of vision
• Diplopia, which is weakness of eye muscles that causes double vision
• Blurred vision
• Problems judging distance
• Involuntary eye movements, called nystagmus
• Photophobia, which is intolerance of light

Effects on hearing

• Decrease or loss of hearing
• Tinnitus, which is ringing in the ears
• Increased sensitivity or intolerance to sounds

Effects on smell and taste

• Anosmia, which is loss of or diminished sense of smell
• Loss of or diminished sense of taste
• Bad taste in the mouth

Social-emotional or behavioral effects

• Dependent behaviors
• Fluctuating emotions
• Lack of motivation
• Irritability
• Aggression
• Depression
• Lack of inhibition
• Denial or lack of awareness

Posted on BrainLine August 9, 2018. Reviewed March 28, 2019.

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The Center of Excellence for Medical Multimedia (CEMM) is a dynamic initiative from the Office of the Surgeon General, supplying award-winning interactive multimedia for patient education throughout the Military Health System.

Center of Excellence for Medical Multimedia. (n.d.). Moderate to Severe TBI: Long-Term Effects. Retrieved March 28, 2019, from https://tbi.cemmlibrary.org/Moderate-to-Severe-TBI/Long-Term-Effects

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[BLOG POST] 7 Common Behavioral Effects of Brain Injury and How to Deal With Them – Jumbledbrain

A brain injury can have various physical, cognitive, medical, emotional, and behavioral effects on head injury survivors. Of these changes, behavioral changes can be one of the most challenging for survivors to overcome to live happier and more independently. To help survivors with traumatic brain injury (TBI), families and caregivers should learn to understand their behavior and develop practical ways to address those challenges.

Why Does Brain Injury Affect Emotions?

Behavioral problems following TBI are often the result of damage to the frontal lobe, the area of the brain that controls “executive functions.” Executive functions refer to the set of skills a person uses to plan, create, evaluate, organize, evaluate, reason, communicate, and solve problems. These impairments have a significant impact on how a person behaves.

Common Behavioral Changes Experienced by TBI Survivors

Human behavior is complex and multi-faceted. This means it can be difficult to isolate which behavior is a result of TBI. A TBI patient’s behavior is, after all, influenced by many different factors, like the nature of the injury, their pre- and post-injury experience, their cognitive abilities, or the behavior of other people. But some of the most common behavior changes encountered by TBI survivors include:

1. Memory Problems

Most people diagnosed with a brain disorder may experience memory problems, but they are more common among TBI survivors as a result of an injury from the bony protrusions inside the skull. Typical situations include forgetting a person’s name, losing a train of thought, and difficulty learning new things.

2. Temper Outbursts

Family members of people with TBI often describe their loved one as someone with a quick temper. They may use bad language, throw objects, or slam doors. Drastic changes like the loss of independence and inability to follow a conversation, in particular, can make a person with TBI more prone to these temper outbursts.

3. Depression

Depression among people with TBI can arise because of the struggle to adjust to disabilities and the changes to one’s role in the family and society. Symptoms of depression include feelings of worthlessness, suicidal thoughts, changes in sleep and appetite, and withdrawal from peers.

4. Poor Concentration

TBI affects a person’s attention and concentration abilities, posing a challenge to work, study, and everyday living. Poor concentration manifests itself in difficulty multitasking, following conversations, and processing information. This happens when the lateral intraparietal cortex—the region of the brain responsible for controlling attention—suffers damage.

5. Self-Centered Attitude

It’s common for TBI survivors to show signs of egocentrism. In turn, this could hamper their ability to see things from another person’s point of view which severely impact their relationship with family members, especially if they used to be a caring person. And although it is often taken for granted, the ability to understand another’s perspective is a complex cognitive skill.

6. Aggressive Behavior

Aggressive behavior following a TBI is often impulsive. A person with TBI can easily grow agitated over trivial disagreements. Experts explain that aggression that happens directly after the TBI is the result of delirium and other post-injury medications. Aggression up to three months after TBI, on the other hand, happens as a result of depression, chronic pain, and post-traumatic stress disorder.

7. Lower Sex Drive

A decreased desire or interest in sex is more common among TBI survivors than heightened libido. Disinhibited sexual behavior can be a possible effect of poor awareness and impulsivity. Changes in sexual functioning following TBI can be due to hormonal changes, medication side effects, fatigue, and movement problems.

Coping with a Loved One with Head Injury

People with TBI showing signs of these behavior problems should be evaluated by a doctor so they can receive proper treatment. On top of medical intervention, friends and family of survivors should also actively participate in rehabilitation, recovery, and advocacy.

1. Set Realistic Expectations

Brain injury has lifelong effects. It pays to understand that a person with TBI might already be trying his or her best. Every member of the family can have different abilities, skills, comfort levels, and limitations, so set small goals and acknowledge that every day is an achievement.

2. Get Involved

Behavioral problems are often hard to deal with. But try to resist the temptation of avoiding difficult situations. People with TBI could end up feeling more confused and isolated if left alone. Instead, get involved and familiarize yourself with their day-to-day routine.

3. Encourage Independence

Learning how to comfort a loved one with TBI is a must. But tread carefully: there is a fine line between caring for people and smothering them with affection. Try to instill independence and study their behavior to know the right time to provide comfort.

4. Reinforce Positive Behavior

What used to come easy to a TBI survivor may now feel extremely difficult. Reinforce positive behavior by focusing on the patient’s strengths, rather than pointing fingers or directing behavior.

5. Rediscover Preferences

Stay alert and pay attention to the wants and needs of a person with TBI. Discover new ways they can engage in activities and establish a balance between easy and difficult tasks. And always encourage them to participate, instead of assuming that their injury makes them unable to.

6. Confide with Loved Ones

Honesty is the best policy, and confiding in friends and family members can help alleviate the burden. Enlisting others for support can provide a fresh perspective and make it easier to identify triggers and how to avoid them.

7. Bounce Back Quickly

Accept that encountering behavioral problems is a part of life. Avoid getting stuck by teaching

new skills while a person is upset. Bounce back quickly from these obstacles then revisit them again later since people aren’t receptive to learning new things when they’re upset.

Other articles you may like:

• I am listening… just my brain injury keeps phasing out.
• Guest post: Rob Dunn on family’s denial of brain injury
• Guest post: Rich Parry-Jones, brain injury survivors husband & carer.
• Is my brain injury making me a bad friend?
• Missing the obvious mistakes after brain injury

Have you or a brain injury survivor you know struggled with these behavioural issues? What advice would you give to others?

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Today’s article is written by Hazel Ann Westco. Hazel Ann Westco is a start-up freelance writer. She is interested in writing blogs and articles related to legal cases mainly in personal injury and employment.  Whenever she has free time she rides her bicycle or motorcycle for a road trip. You can follow her on Twitter using her handle @AnnWestco.

via Guest post: 7 Common Behavioral Effects of Brain Injury and How to Deal With Them | Jumbledbrain